Medicaid does not have to cover the cost of gender-affirming care in Florida, a federal court judge ruled.
As Politico reports, Judge Robert Hinkle denied a preliminary injunction against a state rule that bans Medicaid from paying for gender-affirming care. The injunction request had been filed by a coalition of transgender rights groups that argued Florida violated the equal protections clause of the U.S. Constitution.
Hinkle did not agree, saying the issue is whether Medicaid law has been violated, not the constitutional rights of transgender people. The transgender rights groups also argued that the Florida ban violated anti-discriminatory rules under the Affordable Care Act.
As Politico reports, Hinkle said that “there’s nothing wrong with the state saying they will approve treatment for this and not that. The question here is about the Medicaid statute.”
Simone Chriss, an attorney with the Southern Legal Counsel in Florida who’s one of the lawyers representing the transgender groups, tells The 19th, an online not-for-profit news site that focuses on gender politics, that while Hinkle’s decision is disappointing, the fact that the judge cited Medicaid means that could be a better way to challenge the ban.
The 19th reports that the state rule, created by the Florida Agency for Health Care Administration and that went into effect in August, disproportionately affects low-income trans people.
The injunction had been sought on behalf of August Dekker, Brit Rothstein, a 12-year-old transgender girl called “Susan” in the lawsuit and a 13-year-old, K.F., who is a transgender boy.
Jade Ladue, K.F.’s mother, tells The 19th that she worries that her son’s stomach pains and night terrors might return if gender-affirming care halts because of the Medicaid coverage ban. She tells The 19th that “we live pretty much paycheck to paycheck at this point. There’s no way we could afford a few grand every month, a couple months.”
About 10 states block Medicaid coverage for gender-affirming care. That care can include hormone-blocking medications, behavioral therapy and surgery.
Demand for gender-affirming care among young people has been growing for some time. A Fierce Healthcare article from 2016 reported that “the demand for transgender medical care, including counseling, hormone treatments and genital surgery, is exploding. The more than 30 clinics that provide care for transgender youth across the country are struggling to keep up with the demand."
However, such services have not been without controversy. This year, pediatric hospitals that perform gender-affirming care to minors have been the target of social media harassment campaigns that have led to threatening phone calls, emails and online messages. False accusations from social media users with large followings have led major provider groups including the American Academy of Pediatrics, the American Medical Association and the Children’s Hospital Association to call on the feds to step in.